| dc.description.abstract |
The burden of Plasmodium falciparum (Pf) malaria in Kenya is decreasing; however, it is still one of the top 10
causes of morbidity, particularly in regions of western Kenya. Between April 2015 and June 2016, we enrolled 965
apparently healthy children aged 0–15 years in former Nyanza and Western Provinces in Kenya to characterize the
demographic, geographic, and household risk factors of asymptomatic malaria as part of an epidemiologic study to
investigate the risk factors for endemic Burkitt lymphoma. The children were sampled using a stratified, multistage cluster
sampling survey design. Malaria was assessed by rapid diagnostic test (RDT) and thick-film microscopy (TFM). Primary
analyses of Pf malaria prevalence (pfPR) are based on RDT. Associations between weighted pfPR and potential risk
factors were evaluated using logistic regression, accounting for the survey design. Plasmodium falciparum malaria
prevalence was 36.0% (27.5%, 44.5%) by RDT and 22.3% (16.0%, 28.6%) by TFM. Plasmodium falciparum malaria
prevalence was positively associated with living in the lake-endemic area (adjusted odds ratio [aOR] 3.46; 95% confi-
dence interval [95% CI] 1.63, 7.37), paternal occupation as peasant farmer (aOR 1.87; 1.08, 3.26) or manual laborer (aOR
1.83; 1.00, 3.37), and keeping dogs (aOR 1.62; 0.98–2.69) or cows (aOR 1.52; 0.96–2.40) inside or near the household.
Plasmodium falciparum malaria prevalence was inversely associated with indoor residual insecticide spraying (IRS) (aOR
0.44; 0.19, 1.01), having a household connected to electricity (aOR 0.47; 0.22, 0.98), and a household with two (aOR 0.45;
0.22, 0.93) or 3 three rooms (aOR 0.41; 0.18, 0.93). We report high but geographically heterogeneous pfPR in children
in western Kenya and significant associations with IRS and household-level socioeconomic factors. |
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